Expanding Your Physician Pool With the IMLC

It’s no surprise that in 2025, the physician shortage in the U.S. is still a major news headline. In fact, the Association of American Medical Colleges (AAMC) estimates that the U.S. will face a shortage of up to 86,000 physicians by 2036. While this estimate is lower than it was in 2021, it’s a real-world impact felt by people all over the country, especially in rural and underserved communities.

Although telehealth has improved access to care for many since the COVID-19 pandemic, it doesn’t address the underlying issues—many patients need in-person care or procedures, and licensing across state lines presents a major hurdle for many physicians and facilities.

To maximize new technologies and attract more physicians, state medical boards began meeting in 2013 to work on streamlining the medical licensing process. Out of that work, the Interstate Medical Licensure Compact (IMLC, or Compact) was created in 2017. The IMLC succeeded in streamlining the traditional state-by-state licensing process physicians normally have to go through and increased physician mobility and telehealth opportunities.

Simplifying the medical license process has many benefits, but what does it mean for your facility? How do you use it to increase your candidate pool or find top-tier physicians?

What the IMLC Is

The IMLC is an agreement among participating U.S. states and territories to streamline the licensing process for physicians seeking to practice in multiple states. As of January 2025, the IMLC includes 37 states, the District of Columbia, and the Territory of Guam as members of the Compact. In 2025, four more states introduced legislation to join the IMLC.

At its core, the IMLC is a tool that facilitates information sharing between participating states, expediting the application process for physicians to obtain multiple state medical licenses. The Compact allows eligible physicians to qualify to practice across state lines by completing a single application instead of going through each state’s individual process.

Through the IMLC, states have immediate access to a physician’s file, such as contact details, investigative details, disciplinary actions, CVs, transcripts, and more. This eliminates the time and administrative burden physicians spend uploading documents and answering repetitive questions when applying state by state. It also reduces errors and eliminates the need for various file types and sizes that each state requires to upload documents into its system. 

What the IMLC Is Not

It’s crucial to understand that the IMLC is not a license itself, nor does the IMLC issue licenses. Instead, the IMLC is a tool that participating states use to expedite the application process through information sharing and streamlined requirements. Licensing is still completed through the states. There is no difference between a license issued through the state and one issued through the IMLC.

Think of it like TSA PreCheck – you must still provide fingerprints, documentation, a photo, and payment to TSA. Once approved, you save substantial time bypassing security screening lines at participating airports. The IMLC is similar. It eliminates the need to provide the same information multiple times into different systems – reducing paperwork, errors, and processing time.

Benefits of the IMLC for Healthcare Facilities

The IMLC offers numerous advantages for healthcare facilities. When you are willing to accept IMLC-eligible candidates for your locum tenens jobs, you get:

1. Expanded Candidate Pool: By accepting IMLC-eligible physicians, facilities broaden their pool of qualified candidates beyond those who are already licensed in their state. This is especially beneficial in a tight, candidate-driven job market where top-tier applicants and physicians in sub-specialties are often scarce.
2. Faster Physician Placement: The IMLC dramatically reduces the time it takes for a physician to obtain a license in a new state. While obtaining a license through a state directly can take several months (even up to a year!), the IMLC process takes approximately 30 days for a physician who has never licensed through the IMLC. However, if a physician has received a license through the IMLC in the past, they can obtain additional licenses very fast – often in just a few days! The IMLC’s efficiency allows facilities to implement staffing plans quickly and respond to urgent staffing needs with confidence.
3. Enhanced Flexibility: The IMLC allows healthcare systems that operate across state lines to transfer physicians between facilities more easily. This flexibility is particularly valuable for addressing staffing gaps in rural or underserved areas. Locum tenens physicians often enjoy a varied range of settings, and the IMLC enables them to gain necessary licensure quickly to address your needs.
4. Quality Assurance: Physicians undergo a rigorous vetting process when applying for a state license through the IMLC. This gives facilities confidence in the quality and integrity of the physicians they’re bringing on board. In fact, more than 80% of physicians who apply for a state license through the IMLC are eligible.
5. Improved Patient Access: By making it easier for physicians to practice across state lines, the IMLC helps increase access to healthcare. This can lead to better patient outcomes and potentially higher Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

Physician Requirements for IMLC Eligibility

To qualify for a state license through the IMLC, physicians must meet several criteria:

• Physicians must hold a full, unrestricted medical license in a Compact member state that serves as their State of Principal License (SPL).
• Graduation from an accredited medical school or a school listed in the International Medical Education Directory.
• Successful completion of ACGME or AOA-accredited graduate medical education.
• Physicians must have passed each component of the USMLE, COMLEX-USA, or equivalent in no more than three attempts.
• Current specialty certification or time-unlimited certification by an ABMS or AOABOS board.
• Applicants must have no history of disciplinary actions, criminal history, or controlled substance actions against their medical license, and must not be under current investigation.

It’s important to note that physicians should check their eligibility before applying for a state medical license through the IMLC, as application fees are non-refundable if they are found ineligible. The initial IMLC application fee is $700 plus the state’s licensing fees. When applying for additional licenses, the cost is $100 plus state fees.

While this may sound like a high price to pay, consider the cost of waiting additional weeks or months to bring a qualified physician on board. Some facilities pay for IMLC fees and/or state fees for the locums physician, though this isn’t necessary to attract top-tier physicians. Many pay for the IMLC fees and the state’s licensing fees on their own as part of their locums career.

The IMLC Process

For most physicians, they navigate the IMLC process themselves. However, with Floyd Lee Locums, our concierge service means we can handle the application for them. It also means your facility does not have any administrative burden when selecting an IMLC-eligible candidate (Note: we can also handle credentialing!).

But to give you an idea of how the IMLC works, the process is initiated by applying for a Letter of Qualification from the physician’s State of Principal License (SPL). This step is crucial as it sets the foundation for the entire licensing process. Once the application is submitted, the SPL takes on the responsibility of reviewing the physician’s background and verifying their eligibility for the Compact. This thorough vetting ensures that only qualified physicians proceed through the IMLC system and become eligible for licensing in additional states.

After receiving the Letter of Qualification, the physician selects the Compact state(s) where they wish to practice. The selected state(s) then receive notification of the physician’s qualification and promptly issue licenses based on the Letter of Qualification. Once the license(s) is issued, the facility can proceed with its onboarding process.

If a physician already has a Letter of Qualification when they apply for one of your locums jobs, they can receive their state license within a week (often just a few days!). If a physician has never applied for a state license through the IMLC, the entire process (including obtaining the Letter of Qualification from their SPL) takes about 30 days. Often, we see licenses issued before the facility has even finished credentialing.

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As the healthcare landscape continues to evolve, the IMLC is a powerful tool for facilities looking to expand their physician workforce. By embracing the IMLC and partnering with Floyd Lee Locums, you can turn your staffing challenges into staffing wins.

Are you ready to leverage the power of concierge locums for your facility? We are here to guide you through the process, answer your questions, and help you build the staff of your dreams.